Come join our team as a Utilization Review Specialist, at Oasis Behavioral Health! As part of our team, you will benefit from detailed training, ongoing support, and continued opportunities to develop new skills and move forward in your chosen profession. You'll also know that you are playing a vital role in an organization that is providing an essential service.
We offer a full suite of benefits ranging from:
· Growth Opportunities second to none in the industry
· Competitive hourly rates
· Employee Assistance Program/Employee Discount Program
Pay Range: $27.50 - $35.50 an hour
Flexible hours available for Full Time and Per Diem for Day: Must be able to work weekends, business hours
At Oasis Behavioral Health we specialize in inpatient and outpatient needs of children, teens, and adults. We also have a residential treatment center serving the needs of children and teens. Oasis staff members strive to offer hope to clients who are often suffering from depression, emotional pain, or trauma. Oasis works with clients to define their purpose outside of addiction and mental illness and develop discharge plans that emphasize client strengths, goals, and desired purpose. At Oasis we approach each client with optimism about their future and recovery, addressing each roadblock independently and using setbacks as growth opportunities.
Utilization Review Specialist responsibilities:
· Act as liaison between managed care organizations and the facility professional clinical staff.
· Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
· Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
· Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
· Conduct quality reviews for medical necessity and services provided.
· Facilitate peer review calls between facility and external organizations.
· Initiate and complete the formal appeal process for denied admissions or continued stay.
· Assist the admissions department with pre-certifications of care.
· Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
· Other duties as assigned
Job Requirements:
· Associate's degree in nursing (LPN or RN) required. Bachelor's or Master’s degree in social work, behavioral or mental health, nursing or other related health field preferred.
· Two or more years' experience with the population of the facility and previous experience in utilization management preferred.
Job Types: Full-time, Part-time
Pay: $27.50 - $35.50 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Free parking
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Tuition reimbursement
- Vision insurance
Healthcare setting:
- Acute care
- Hospital
- Inpatient
Medical specialties:
Schedule:
- 8 hour shift
- Monday to Friday
- Weekends as needed
Education:
Experience:
- Utilization review: 2 years (Required)
Ability to Relocate:
- Chandler, AZ 85225: Relocate before starting work (Required)
Work Location: In person